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Self-reported symptoms and exercise-induced asthma in the elite athlete

RUNDELL, KENNETH W.; IM, JOOHEE; MAYERS, LESTER B.; WILBER, RANDALL L.; SZMEDRA, LEON; SCHMITZ, HEATHER R.

Medicine & Science in Sports & Exercise: February 2001 - Volume 33 - Issue 2 - p 208-213
CLINICAL SCIENCES: Clinical Investigations

RUNDELL, K. W., J. IM, L. B. MAYERS, R. L. WILBER, L. SZMEDRA, and H. R. SCHMITZ. Self-reported symptoms and exercise-induced asthma in the elite athlete. Med. Sci. Sports Exerc., Vol. 33, No. 2, 2001, pp. 208–213.

Purpose: The purpose of this study was to compare self-reported symptoms for exercise-induced asthma (EIA) to postexercise challenge pulmonary function test results in elite athletes.

Methods: Elite athletes (N = 158; 83 men and 75 women; age: 22 ± 4.4 yr) performed pre- and post-exercise spirometry and were grouped according to postexercise pulmonary function decrements (PFT-positive, PFT-borderline, and PFT-normal for EIA). Before the sport/environment specific exercise challenge, subjects completed an EIA symptoms-specific questionnaire.

Results: Resting FEV1 values were above predicted values (114–121%) and not different between groups. Twenty-six percent of the study population demonstrated >10% postexercise drop in FEV1 and 29% reported two or more symptoms. However, the proportion of PFT-positive and PFT-normal athletes reporting two or more symptoms was not different (39% vs. 41%). Postrace cough was the most reported symptom, reported significantly more frequently for PFT-positive athletes (P < 0.05). Sensitivity/specificity analysis demonstrated a lack of effectiveness of self-reported symptoms to identify PFT-positive or exclude PFT-normal athletes. Postexercise lower limit reference ranges (MN-2SDs) were determined from normal athletes for FEV1, FEF25–75% and PEF to be −7%, −12.5%, and −18%, respectively.

Conclusion: Although questionnaires provide reasonable estimates of EIA prevalence among elite cold-weather athletes, the use of self-reported symptoms for EIA diagnosis in this population will likely yield high frequencies of both false positive and false negative results. Diagnosis should include spirometry using an exercise/environment specific challenge in combination with the athlete’s history of asthma symptoms.

Sports Science and Technology Division, United States Olympic Committee, Lake Placid, NY 12946

March 2000

May 2000

© 2001 Lippincott Williams & Wilkins, Inc.